Setting Up UB Claims for Enhanced UB Users

Help Guide for NextGen® Enterprise PM 8

Setting Up Encounters for UB Claims

The following list outlines the areas of the Encounter Maintenance window that are important to the setup of UB claims: On the General tab, complete the Service Location field. On the UB tab, access the following sub-tabs: Condition Codes, Occurrence Codes, and Value Codes. Encounter Maintenance Note: For Enhanced UB users, the automated UB claims process only applies to payers who are considered primary. The automating of the Type of Bill field, the Occurrence codes, and the Value codes, which are explained in the following sections, only occurs for primary payers who have the required criteria. UB/General Tab UB/Condition Codes Tab UB/Occurrence Codes Tab UB/Value Codes Tab Setting Up Practice Preferences for UB Claims Parent topic: UB Claims

Help Guide for NextGen® Enterprise PM 8

Setting Up the Service Location

When an Enhanced UB user bills a UB encounter using the automated claims process for primary payers, the Service Location field cannot be accessed and changed. However, if you have billed a UB encounter to a secondary or tertiary payer, then this field will not be locked down after you bill the encounter. Parent topic: UB Claims

Help Guide for NextGen® Enterprise PM 8

Setting Up Practice Preferences for UB Claims

To set up a payer for UB claims, two fields must be set up in Practice Preferences > Claims in the UB Claim > Form section: Type of Facility Bill Classification When the above fields are populated, a UB tab displays in the following areas on the Modify Payer Information window: System > Claims > Provider Secondary References > UB Claims Practice > Claims > UB Claims Practice > Secondary References > UB Claims Practice > UB Parent topic: Setting Up Encounters for UB Claims Parent topic: UB Claims

Help Guide for NextGen® Enterprise PM 8

Recurring UB Billing

Recurring UB billing is a process that enables you to indicate a treatment plan by linking claims using onset date, discharge date, default value code, and occurrence codes. These values are then copied forward from one encounter to the next. Default value and occurrence codes, which are set up in the Revenue Codes master file, automatically post to the encounter during billing if recurring billing is enabled. For the interim and final claims in the series, the onset date, value codes, and occurrence codes can be copied forward from the initial encounter. Recurring billing is used for billing a series of visits for the following therapies: Physical therapy Speech therapy Occupational therapy Note: The application currently works only for the revenue codes that represent the above therapies. File Maintenance Settings Required for Recurring UB Billing Setting Up UB Claim Forms Encounter Settings Required for Recurring UB Billing Parent topic: UB Claims

Help Guide for NextGen® Enterprise PM 8

Set Up Electronic UB Claims

To submit claims electronically, you need to set up the UB Claims tab for the payer on the Add/Modify Payer Information window. Following is a list and explanation of the fields and check boxes in the UB Claims section to enable UB claims generation and electronic claim submission: The Field Locator 51 field The Media Type (Primary, Secondary, Tertiary) fields The When Primary, force Secondary claims to paper check box The When Secondary, force Tertiary claims to paper check box The Suppress Claim check box The fields and check boxes on the UB Claims tab are listed below with an explanation. The Field Locator 51 field. This is a free-form text entry field. Enter the number provided to you by the payer. This field must be completed when creating a UB claim. If it is left blank, then an edit will occur during the claims process, which reads: Loc 51 Provider Number is missing. The Media Type (Primary, Secondary, Tertiary) fields. The two Media Type options available are Paper and Electron

Help Guide for NextGen® Enterprise PM 8

Setting Up UB Claims for Enhanced UB Users

Setting up UB claims for Enhanced UB users is different from the set up for Regular UB users, especially if you want to use the automated claims process. For Enhanced UB users, the automated UB claims process only applies to payers who are considered the primary payer. The automated UB claims process is not for payers who are considered secondary or tertiary. The automating of the Type of Bill field, the Occurrence codes, and the Value codes only occurs for primary payers who have the required criteria. Set Up Payers for Enhanced UB Users Set Up Encounters for Enhanced UB Claims (Before Billing) Set Up Encounters for Enhanced UB Claims (After Billing) Parent topic: UB Claims

Setting Up UB Claims for Enhanced UB Users

Recommendations

Setting Up Encounters for UB Claims

Setting Up the Service Location

Setting Up Practice Preferences for UB Claims

Recurring UB Billing

Set Up Electronic UB Claims

Setting Up UB Claims for Enhanced UB Users

Setting Up UB Claims for Enhanced UB Users

Setting Up Encounters for UB Claims

Setting Up the Service Location

Setting Up Practice Preferences for UB Claims

Recurring UB Billing

Set Up Electronic UB Claims

Setting Up UB Claims for Enhanced UB Users